Articles: paranasal-sinuses-diagnostic-imaging.
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Otolaryngol. Clin. North Am. · Jun 1997
ReviewCurrent status and new developments in techniques for imaging the nose and sinuses.
CT scans and MR images have matured as the mainstays of imaging of the nasal cavity and paranasal sinuses. This review covers the current status of imaging in regards to benign and malignant sinus disease. A review of current imaging methodology and a look at emerging technologies, which hold promise for evaluating the proximal airways, is provided.
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Recent changes in sinonasal imaging are a direct result of the development of functional endoscopic sinus surgery. Because of this technique, radiologists have noted an increased volume of sinus imaging, developed new imaging techniques, and are interpreting films in a different manner. This article covers the common variants seen on coronal computed tomography, discusses the complications of functional endoscopic sinus surgery, reviews the radiographic criteria for sinusitis, and addresses the role of computed tomography and magnetic resonance imaging in evaluating the sinonasal cavity.
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Chronic rhinosinusitis endoscopic surgery needs an accurate evaluation of diseases and paranasal sinus anatomic variations. High resolution CT by thin section (2 mm) allow this pre-operative assessment. ⋯ They are nasal septal deviation, pneumatization and paradoxical curvature of the middle turbinate, pneumatization of unciform process, Haller's cells, prominent agger nasi cell and ethmoid bulla. The endoscopic endonasal surgery landmarks, the individual morphologic variations, the topographic relations to the orbit and to the brain are also well shown by CT.
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Comparative Study
Radiography and ultrasonography in paranasal sinusitis.
In order to analyze whether ultrasonography with a reasonable degree of confidence can replace radiography in the diagnosis of sinusitis, 138 patients with clinical signs of sinusitis were examined with both methods. It was found that maxillary sinus fluid was recognized ultrasonographically with a confidence that increased with the amount of fluid, judged from radiographic examinations. In a sub-group of 45 cases, fluid confirmed by maxillary sinus puncture was detected by ultrasonography in 35/45 sinuses (78%) and by radiology in 38/45 sinuses (84%). ⋯ However, mucosal swelling and polyps or cysts observed at radiography were poorly demonstrated by ultrasonography. In addition, the ultrasound method was not reliable for frontal sinus diagnosis. It was concluded that ultrasonography can be recommended in maxillary sinusitis for follow-up of treatment and as a screening method before sinus radiography.